Relegated To Bed Rest
Contributed by Nancy Gottesman
More than 700,000 pregnant women a year in the U.S. are prescribed some level of bed rest each year as a result of such factors as threatened preterm labor, spotting, bleeding, hypertension and, frequently, carrying twins or more. Most take to their beds (or couches) willingly despite the obvious — and tremendous — stress doing so puts on themselves and their families. “Women are highly motivated because their biggest concern is their unborn child,” says Judith A. Maloni, Ph.D., R.N., one of the nation’s leading researchers on pregnancy bed rest and a professor of nursing at Case Western Reserve University in Cleveland.
The positives of bedrest
While bed rest is one of the most often prescribed interventions during pregnancy, it is also one of the least studied. However, says Maloni, “The current evidence indicates that bed rest is not effective for preventing preterm birth.” One study compared women who had been on bed rest with women who had not and found that the preterm birth rates (before 37 weeks) were similar — 7.9 percent and 8.5 percent, respectively.
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Nonetheless, bed rest may have some value. “I think it might be helpful in keeping women with preeclampsia pregnant a little longer,” says Pamela Berens, M.D., an associate professor in the department of obstetrics and gynecology at the University of Texas Medical School at Houston. “Bed rest may also increase blood flow to the uterus and placenta and help babies grow better.” Additionally, Berens says, it can take pressure off the cervix, which may help manage symptoms of preterm labor.
The toll it takes
Bed rest is anything but restful: Common emotional and psychological side effects include boredom, stress, guilt and depression. Then there’s the physical toll: “Muscle atrophy can begin in 24–48 hours,” says Maloni, who cites her own studies as well as those conducted on astronauts that show bed rest can very quickly lead to muscle deconditioning.
“It’s worse in weight-bearing muscles like the legs, back and neck,” Maloni says, adding that no research shows physical therapy can maintain muscle strength during bed rest. Still, with your doctor’s OK, there are things you can do to minimize muscle soreness, poor circulation and lethargy as well as help prevent dangerous blood clots.
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After giving birth, many new moms who were on bed rest come home suffering from fatigue plus back and muscle aches. “It’s tough because they have to care for a baby and they didn’t expect to be deconditioned,” Maloni says. So what do you do if your doctor prescribes bed rest? “I tell women to get a second opinion from a perinatologist [a high-risk OB],” says Maloni.
“If you’re having preterm labor symptoms, you should be seeing this kind of specialist anyway.” Despite what studies show, most women will do anything they can to try to help their babies. Today, Christina Stevens, 31, of Columbus, Ohio, has three healthy children, but she spent two of her pregnancies largely on bed rest due to preterm labor symptoms. “I kept thinking, ‘Why can’t I have a normal pregnancy?’” Stevens recalls. “But you’re more concerned about your baby’s health than your own needs — you’ll do anything you can to try to get to 36 weeks.”